PDF(Pubmed)
Abstract：
UNASSIGNED: Scedosporium apiospermum (SA) is commonly present in temperate climates. It can induce cutaneous and subcutaneous tissue infections as well as disseminated infections in immunocompromised or immunocompetent hosts. The eye is rarely involved. Keratomycosis is usually caused by plant-related injuries. Here, we describe a patient with a severe and sight-threatening corneal abscess caused by SA, which was associated with contact lens wear and was successfully treated with a combination of surgical and medical therapies.
UNASSIGNED: An otherwise healthy 22-year-old woman, with history of contact lens wearing, was referred to the Ophthalmic Department of Bari University, Bari, Italy for evaluation of a corneal abscess and hypopyon in her left eye. Intensive topical and systemic antibiotic therapy was initiated after obtaining con- junctival swabs. Within 2 days, her ophthalmic condition had worsened, and her best-corrected visual acuity (BCVA) dropped to counting fingers. She underwent penetrating keratoplasty, after which her ophthalmic condition improved. Microbiological culture, obtained from the explanted cornea, revealed SA infection. This was addressed with specific topical and systemic therapy using voriconazole. Two weeks later, the con- dition of her left eye was stable, with mild corneal edema and no sign of acute graft rejection. Her BCVA improved to 20/25, and all medications were discontinued, except for the steroid eye drop. The patient was scheduled for a 1-month follow-up.
UNASSIGNED: Prompt identification of the etiological agent is mandatory to perform appropriate therapy in cases of keratomycosis. Surgery to remove the infected cornea is helpful in patients with deteriorating condition, in whom the initial medical therapy has failed. Topical and systemic antimycotic therapy, based on microbiological culture, is recommended as an adjunctive therapy for the surgical management of severe corneal mycotic abscesses.
UNASSIGNED: An otherwise healthy 22-year-old woman, with history of contact lens wearing, was referred to the Ophthalmic Department of Bari University, Bari, Italy for evaluation of a corneal abscess and hypopyon in her left eye. Intensive topical and systemic antibiotic therapy was initiated after obtaining con- junctival swabs. Within 2 days, her ophthalmic condition had worsened, and her best-corrected visual acuity (BCVA) dropped to counting fingers. She underwent penetrating keratoplasty, after which her ophthalmic condition improved. Microbiological culture, obtained from the explanted cornea, revealed SA infection. This was addressed with specific topical and systemic therapy using voriconazole. Two weeks later, the con- dition of her left eye was stable, with mild corneal edema and no sign of acute graft rejection. Her BCVA improved to 20/25, and all medications were discontinued, except for the steroid eye drop. The patient was scheduled for a 1-month follow-up.
UNASSIGNED: Prompt identification of the etiological agent is mandatory to perform appropriate therapy in cases of keratomycosis. Surgery to remove the infected cornea is helpful in patients with deteriorating condition, in whom the initial medical therapy has failed. Topical and systemic antimycotic therapy, based on microbiological culture, is recommended as an adjunctive therapy for the surgical management of severe corneal mycotic abscesses.
摘要：
■Scedosporiumapiospermum（SA）通常存在于温带气候中。它可以在免疫受损或免疫活性宿主中诱导皮肤和皮下组织感染以及播散性感染。眼睛很少参与。角质病通常由植物相关损伤引起。这里,我们描述了一个由SA引起的严重且危及视力的角膜脓肿的患者，这与隐形眼镜佩戴有关，并通过手术和药物治疗的组合成功治疗。
■一个健康的22岁女性，有隐形眼镜佩戴史,被转介给巴里大学眼科，巴里,意大利用于评估她左眼的角膜脓肿和房囊不足。在获得结膜拭子后开始强化局部和全身抗生素治疗。2天内,她的眼科状况恶化了，她的最佳矫正视力（BCVA）下降到数指。她接受了穿透性角膜移植术,之后，她的眼科状况有所改善。微生物培养,从移植的角膜获得，显示SA感染。通过使用伏立康唑的特定局部和全身治疗解决了这一问题。两周后,她左眼的状态很稳定,轻度角膜水肿，无急性移植排斥反应。她的BCVA提高到20/25，所有药物都停药，除了类固醇滴眼液.患者计划进行1个月的随访。
■在角膜真菌病的情况下，必须迅速识别病因以进行适当的治疗。手术切除受感染的角膜有助于病情恶化的患者，最初的药物治疗失败了。局部和全身抗真菌治疗，基于微生物培养，建议作为严重角膜霉菌性脓肿手术治疗的辅助疗法。
■一个健康的22岁女性，有隐形眼镜佩戴史,被转介给巴里大学眼科，巴里,意大利用于评估她左眼的角膜脓肿和房囊不足。在获得结膜拭子后开始强化局部和全身抗生素治疗。2天内,她的眼科状况恶化了，她的最佳矫正视力（BCVA）下降到数指。她接受了穿透性角膜移植术,之后，她的眼科状况有所改善。微生物培养,从移植的角膜获得，显示SA感染。通过使用伏立康唑的特定局部和全身治疗解决了这一问题。两周后,她左眼的状态很稳定,轻度角膜水肿，无急性移植排斥反应。她的BCVA提高到20/25，所有药物都停药，除了类固醇滴眼液.患者计划进行1个月的随访。
■在角膜真菌病的情况下，必须迅速识别病因以进行适当的治疗。手术切除受感染的角膜有助于病情恶化的患者，最初的药物治疗失败了。局部和全身抗真菌治疗，基于微生物培养，建议作为严重角膜霉菌性脓肿手术治疗的辅助疗法。
